How to Protect Kids From the Flu

IIt’s the time of year when parents feel hyper-anxious about their child catching the flu. School is in session, there’s lots of upcoming travel, and the virus is circulating.

While there’s no need to panic — and many fears are unfounded — it is true that the flu can be dangerous for young ones. Robert A. Finkelstein, MD, of the Division of Pediatric Emergency Medicine of Weill Cornell Medicine, says he often sees young children in the emergency room during flu season. “We see many children with the flu, particularly between late October and late April.”

Children younger than five years old — and especially those younger than two— are at a higher risk for developing complications from the flu, like pneumonia. During the 2018–2019 flu season, 116 children died from the flu. About half of the deaths were among kids who were otherwise healthy. The majority of these deaths were in children who did not get the flu vaccine.

Here is the best way to protect kids from the flu and take care of them if they catch it.

Put the flu shot on your to-do list

There are good habits you can adopt during peak flu season, like making sure children are washing their hands often and trying to keep them away from people who are sick. But “the best way by far” to prevent complications from the flu is by getting the flu shot, for both you and your child, Finkelstein said. “There are different types of influenza viruses, and they can mutate or change, so it is difficult to make a perfect vaccine that protects against every strain. However, the most common strains are covered by the vaccine and even if you get the flu, it is often milder if you have been vaccinated.”

Children ages nine and older need only one dose of influenza vaccine. Children ages six months to eight years old may need two doses if it’s their first time receiving the flu vaccine or if they have not received two doses of vaccine prior to July 1, 2019 (which means they are unprotected for this year’s flu season).

For babies, the best protection begins in the womb. When mom has a flu shot during pregnancy, the antibodies pass through the placenta to help protect the baby from the flu, even after birth. (Children cannot get a flu shot until they are six months old, which means that by getting your child vaccinated, you’re also helping protect babies until they are old enough to be vaccinated themselves.)

For needle-shy kids, consider the nasal spray vaccine

The nasal spray mist is a live attenuated influenza vaccine (which means it contains live but weakened flu viruses), whereas the flu shot contains flu viruses that have been biologically altered to remove their ability to infect the body.

Both options have been reviewed by the Centers for Disease Control and the American Academy of Pediatrics for effectiveness during this year’s flu season, and neither agency recommends one over the other — meaning the nasal spray is a great choice for children older than two who are scared of needles.

Remember: The flu vaccine won’t give your kid the flu

“Many have heard that the flu vaccine is not very effective, can give you the flu, or might be dangerous,” Finkelstein says. A 2018 survey conducted by Orlando Health Arnold Palmer Hospital for Children found that more than half of the parents surveyed believed their child could contract the flu from the flu shot. This is not true.

The jitters around the vaccine are understandable — after all, the flu vaccine does contain a version of the flu virus, and the nasal flu vaccine in particular contains a live virus. But all vaccines contain a small amount of the virus or bacteria they work to prevent. “The virus in the flu vaccine is inactivated, cannot reproduce, and cannot give you the flu,” Finkelstein says.

Sometimes people get the flu soon after or around the same time they received the flu vaccine, but Finkelstein says this is typically just a coincidence, or, someone already contracted the flu before getting the vaccine. In some rare cases, people can have an immune response to getting the vaccine which could result in mild flu-like symptoms that last for a couple days.

“A child is not likely to become ill from the vaccine and is much more likely to become ill from the flu which can lead to hospital admission, respiratory failure, and other serious conditions,” says Finkelstein. The best option, he says, is to have your child vaccinated.

But your kid might get sick anyway, so learn how to recognize the symptoms

A cold is not the flu. An upset stomach is not the flu. We tend to label any wintertime illness as “flu,” even those that have “nothing to do with influenza infection,” said Tina Q. Tan, MD, an attending physician at Ann & Robert H. Lurie Children’s Hospital of Chicago.

While the common cold usually takes a few days to build up, the flu will appear in a child quite suddenly.

The common cold and the flu are both viruses that share some similar symptoms, including cough, fatigue, runny nose, and sneezing. But there are some key differences: For one, cold symptoms are typically milder and do not result in the same serious health complications that the flu can in children. For another, while the common cold usually takes a few days to build up, the flu tends to appear in a child (or an adult) quite suddenly. Finally, keep an eye out for the flu’s more distinct symptoms — high fever, body aches, vomiting, and diarrhea — especially in younger children. “It’s not always an easy diagnosis, as many viruses can mimic the flu,” said Finkelstein. “However, high fever, body aches, malaise, and trouble breathing in a patient during the late fall to early spring are often suggestive of the flu.”

If your kid does have the flu, here’s what to do next

If parents are worried their child has the flu, they should contact their health care provider to receive a diagnosis and discuss next steps. Antiviral medications can lessen flu symptoms, such as fever, and shorten the length of time a person feels sick by about one day. In children particularly, antivirals may reduce the risk of flu-related complications such as ear infections, and lower the risk of hospitalization, according to the CDC. They are not, however, the first line of defense against the flu. That’s the flu vaccine.

Even if your child has already had the flu this year, it’s still worth getting them vaccinated, because the flu vaccine can protect against the three other strains of the virus. Talk to your child’s doctor, of course, but it’s recommended to wait to get the flu vaccine until they’re fully recovered: The flu vaccine works by triggering an immune response, which means they might face a longer recovery time from their illness or a reduced response to the vaccine if they get it while they’re already sick with the flu.

Advice for flu season, and for life: You can only control yourself

No matter how conscientious you are about getting yourself and your child vaccinated early in the flu season, you can’t control what other parents or your co-workers do. (Though some states do require the flu vaccine to enter school and others are strengthening requirements for school vaccinations overall.) “Unfortunately, we probably come in contact with unvaccinated children every day,” says Dionne Smith, MD, a pediatrician at Carle Foundation Hospital. “When it comes to the flu vaccine, we are faced with much lower rates of vaccination than we are with other routine vaccines.”

Even still, the best way to protect your child is by getting them the flu shot. “The child’s risk of contracting influenza is then decreased, and even if she comes in contact with it and does end up getting influenza, the illness will be less severe and the risk of complications and hospitalization significantly reduced,” said Smith.

In addition to the vaccine, Smith recommends one other good old-fashioned disease prevention method.“I typically recommend excellent hand washing throughout the day during the cold and flu season,” she said. Though we can’t control the spread of germs, these two precautions are certainly enough to ease some of the flu-season anxiety.

Illustrations by George Wylesol

This story is part of “The Elemental Guide to This Year’s Flu,” a multi-story special report.

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